Starting in a CCU LTAC from a SNF wound unit - page 2
by SusieN RN
Hi everyone. I thought this would be the best place to make this post. I graduated in January 2009 from the associates RN program at Northampton Community College (wanted the BSN, but I was in my 20s and paying for most of my... Read More
- 1Dec 7, '11 by poopprincessI work in LTAC, not Kindred, but my place is pretty much exactly the same. Our TCU (vent pts.) don't have the A-lines and such though. Those are in our ICU. However, LTAC is def. a great place to learn but you will work your butt off. Almost of the pts. are total care, turn Q2h, Peg tubes, feeds, TPN, post-op complications, CABG or abdominal surgery, ICH, staples/suture removals, ostomies, central lines, PICC lines, trach care. Vent weaning is what most of them are there for. There is halo traction, infections, tele, tons of wound care-complex wounds, wound vacs, renal failure and much more. We do draw our own labs, and many of these pts. are renal, so once you get it down, you are good to go. I have learned not only how to stick someone, but how to feel for a vein that I can't see and still get it. I'm no pro, but I'm making progress and can sometimes get a hard-stick. These pts. are SICK. People tend to underestimate just how sick they really are. Also, there is not a Dr. in our building at night, so nurses run the codes. There are protocols and the charge will call and inform the MD on call of what is going on, but they are not physically there. They will come in later if there is a code, or if a pt. needs a procedure done (bleeding trachs). Really, Esme just nailed it in her description.
The respiratory thereapy team is great and they are a wonderful source of info. I ask them a gazillion questions all of the time. As a matter of fact, I get to take care of the sicker pts. because I actively seek out new info and prove I can handle it. I am a new grad and this the only nursing job that I have ever had. I wanted to quit in the beginning, but I am glad I stuck it out. I wouldn't leave for a med-surg position in the hospital, but I would for ED or ICU.
Your wound care experience should serve you well in this position. There is a lot to learn and you will be busy. The ratio is by no means an easy one. We also get 4:1 vents or 6:1 if med-surg. The med-surg pts. are sometimes harder than the ventilated ones because they are more demanding. They usually started in the ICU/TCU and were moved once their acuity lessoned. They tend to get lonely and become quite needy. Also chronic pain is an isssue with many of them. There is also hospice or unexpected deaths. I will tell you that sometimes the death is bothersome because they pts. are there for a long time so you really get to know them and their families. It's not always easy to shake it off if it's someone you knew well who was progressing and then BAM. Anyways-GOOD LUCK to you! CONGRATS. Take advantage of the situation and learn all you can. Everyday is pretty much resume building. I actually have grown to like it, I do want a full time position elsewhere, but even if I get one, I'll stay here PRN. You see it all.